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Host Defense Exam 2 > PNI > Flashcards

PNI Flashcards

1
Q

Define the direct connection between CNS and immune system.

A
  • neuronal
  • innervation of primary and secondary lymphoid organs (PVN)
  • innervation of adrenal medulla (splanchnic)
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2
Q

Define the indirect connection between CNS and immune system.

A
  • neuroendocrine

- via neurohomormones

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3
Q

Describe the activation process of the neuroendocrine connection.

A
  1. Physical or psychological stressor causes release of ACh, GABA, catecholamines, or serotonin
  2. These activating factors stimulate the PVN of the hypothalamus to release CRH
  3. CRH goes to the anterior pituitary to stimulate release of ACTH
  4. ACTH activates adrenal cortex to release cortisol
  5. cortisol has an inhibitory effect on immune cells
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4
Q

Describe the activation process of the neuronal connection.

A
  1. peripheral nerves directly innervate primary and secondary lymphoid organs
  2. sympathetic splanchnic nerves innervate the adrenal medulla to release catecholamines
  3. catecholamines, ACh, and neuropeptides directly bind to immune cells (lymphocytes, neutrophils, mononuclear cells, and NK cells)
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5
Q

Bone marrow is stimulated by..?

A

noradrenergic fibers (norepinephrine)

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6
Q

Thymus is stimulated by…?

A
  • noradrenergic
  • cholinergic
  • peptidergic
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7
Q

Spleen is stimulated by…?

A
  • noradrenergic
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8
Q

Lymph nodes are stimulated by…?

A
  • noradrenergic

- peptidergic

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9
Q

All primary and secondary lymphoid organs respond to…?

A

norepinephrine

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10
Q

Which immune cells respond to catecholamines, ACh, and neuropeptides?

A
  • T and B lymphocytes
  • mononuclear cells
  • NK cells
  • neutrophils
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11
Q

What is the effect of cortisol on immune cells?

A
  • anti-inflammatory
  • reduces inflammatory cytokine production
  • reduces T and B cell reactivity
  • reduces NK cell activity
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12
Q

What is the effect of catecholamines on immune cells?

A
  • leukocyte mobilization

- increased NK cell activity

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13
Q

What is the effect of endorphins on immune cells?

A
  • made from POMC and split into ACTH and endorphins when CRH is released
  • analgesia
  • increase T and NK cell reactivity
  • act like hormones
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14
Q

What is the effect of enkephalins on immune cells?

A
  • analgesia
  • released from brain, pituitary, and adrenal medulla
  • increase T and NK cell reactivity
  • act like neurotransmitters
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15
Q

Describe the physiological effect of acute controllable stress.

A
  • increased HR
  • increased catecholamines
  • increased cortisol
  • increased number of circulating leukocytes
  • increased NK cells and activity
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16
Q

What is the main cause of increased NK cell activity during acute stress?

A

catecholamines

17
Q

What happens 1 hour after an acute stress?

A
  • normalization of circulating leukocytes
  • leukocytes have localized to their regional lymph nodes
  • allows you to fight off infection and wounds that may have occurred during the “fight or flight” response
  • due to catecholamines and cortisol
18
Q

What is the reason for lymphocyte localization after an acute stressor?

A
  • cortisol
  • catecholamines
  • adhesion molecule modification (increased expression of CD11a, increased expression of ICAM on endothelial cells
19
Q

Describe the effect of cortisol on delayed type 4 hypersensitivity (DHT) responses.

A
  • small doses = increased response
  • large doses = decreased response
  • chronic doses = decreased response
  • acute doses = increased response
    ===> chronic stress depresses the immune system
20
Q

What are physiological markers of chronic stress (from taking care of an ill patient)?

A
  • decreased cytokine production (IL-1, IL-2)
  • decreased antibody production
  • increased frequency of colds
21
Q

Which cytokines can have an effect on the CNS?

A
  • IL-1
  • IL-6
  • TNFa
22
Q

What effect do cytokines have on the CNS?

A
  • change firing frequency => influence secretion of HPA axis (ACTH)
23
Q

Which cells can produce neurotransmitters/neuropeptides? Which neurotransmitters do they produce?

A
  • T and B cells
    => ACTH
    => beta-endorphins
    => enkephalins
24
Q

What effect do endorphins and enkephalins secreted by immune cells have?

A

analgesia at site of infection

25
Q

Define sickness behavior.

A
  • cytokines produced as a result of an infection (IL-1, IL-6, TNFa) modify behavior through the CNS
  • characterized by fever, fatigue, headache, diminished appetite, muscle and joint pain
  • cytokines alert brain to injury/infection and communicates body’s distress
26
Q

How do cytokines stimulate sickness behavior?

A
  • circulation (BBB => CVO => prostaglandins)

- afferent neurons

27
Q

Describe the cholinergic anti-inflammatory pathway.

A
  1. splenic nerve releases norepinephrine on beta-2 adrenergic receptors on the surface of T cells
  2. T cells secrete ACh that interacts with alpha-7 surface receptors of macrophages in the spleen
  3. ACh inhibits IL-1, IL-6, and TNFa production by macrophages and diminishes inflammatory response
28
Q

Describe the immune response timeline during acute stress.

A
  1. immediate release of catecholamines mobilizes immune cells to prep for infection
  2. slow release of cortisol diminishes the immune response and causes leukocyte localization; this also diverts energy to muscles, heart, and sensory organs for fight or flight
  3. after acute stress is over, catecholamines and cortisol decrease to normalize immune cell levels in circulation

Host Defense Exam 2 (11 decks)

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